Our Services
At Shores Insurance, we are dedicated to delivering outstanding customer support. Our team offers personalized guidance, answers questions, and will help you choose coverage suited for your needs. Whether you're exploring plan options, managing claims, or making policy adjustments, we’re with you every step of the way. Reach out to us today and experience the exceptional care and expertise that makes us different!
Personalized Coverage Guidance
Our experts offer one-on-one consultations to help you choose the right health insurance plan for your needs, budget, and health goals.
Claims Support
We help clients navigate the claims process by explaining processing times, identifying coding errors, and addressing delays or denials. Additionally, we educate you on how to avoid issues and ensure timely approvals.
Plan Comparison Quotes
We provide clear, easy to understand quotes to help you compare plans and choose coverage best suited for you and your family.
Coverage Reviews
We offer annual plan reviews to ensure your current coverage still meets your needs and help you make adjustments if necessary.
Health and Wellness Resources
As part of our commitment to your well being, we help members access the educational resources, wellness programs, and tips included with most plans that can help you maintain a healthy lifestyle.
Prescription Assistance
We assist with understanding prescription coverage and locating in-network pharmacies to save on prescription costs. We also educate on available resources outside of insurance to help you find the lowest out of pocket cost options such as manufacturer coupons, patient assistance programs, mail order services, etc.
Enrollment Assistance
We guide you through the application process to ensure quick and accurate enrollment, to avoid delays in coverage.
Ongoing Customer Support
Access reliable customer service whenever you need it; whether it’s helping you understand your benefits, updating your information, or resolving issues with your plan.
Billing and Payment Assistance
Our team is available to help you understand your billing statements, answer questions about premiums, and assist with payment processing to keep your coverage active.
Special Enrollment Assistance
If you qualify for a Special Enrollment Period, we provide support to help you navigate the process and get the coverage you need during qualifying life events.
Provider Network Help
We help you understand which doctors, hospitals, and specialists are included in your network, ensuring you get the most value and savings from your plan.
Policy Updates and Changes
We keep you informed of important updates regarding any changes to your policy benefits, alternative coverage options, and regulation/legislative changes.
Client Responsibilities and Expectations
Provide Accurate Information
Clients are expected to provide accurate and up to date personal, financial, and health information to ensure proper coverage, eligibility, and claims processing.
Notify Us of Changes
Clients are responsible for promptly notifying us of any changes to their personal circumstances, such as updates to their address, income (if receiving assistance from certain programs), or family status. This ensures their coverage remains in effect and up to date.​
Understand Your Coverage
Clients are encouraged to ask questions and fully understand their plan’s terms, conditions, and limitations to make the most of their coverage. We believe that successful outcomes are a result of active collaboration. We encourage our clients to engage fully during appointments by taking notes and actively referencing the materials provided. This ensures a productive and efficient experience, allowing us to better address your needs and goals.
Notify Us of Special Enrollment Periods
Clients should promptly inform us of any changes in their life circumstances—such as marriage, the birth of a child, or the loss of other coverage—that may qualify them for a Special Enrollment Period.
Review Plan Details
Clients are responsible for carefully reviewing all plan details, including coverage options, benefits, and exclusions. This ensures the chosen plan aligns with their healthcare needs, helps them understand how to use their benefits effectively, and minimizes unnecessary costs.
Pay Premiums on Time
Clients are responsible for paying premiums on time to maintain uninterrupted coverage and avoid potential lapses in insurance.
Adhere to Network Guidelines
Clients should familiarize themselves with their plan's network providers and make use of in-network services whenever possible. This helps maximize benefits and minimize additional out-of-pocket costs.
Cooperate with the Claims Process
Clients must work with our team and billing providers to resolve claims or disputes by providing requested documentation. To assist effectively, we need complete information, including service dates, billed amounts, billing providers, and procedure codes.
We recommend verifying that doctors and facilities are in-network and confirming coverage details before receiving services to avoid unexpected costs.
